Provider Demographics
NPI:1164410932
Name:IOWA HEART CENTER PC
Entity Type:Organization
Organization Name:IOWA HEART CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICE
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-633-3970
Mailing Address - Street 1:5880 UNIVERSITY AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-8220
Mailing Address - Country:US
Mailing Address - Phone:515-633-3838
Mailing Address - Fax:515-633-3837
Practice Address - Street 1:5880 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-8220
Practice Address - Country:US
Practice Address - Phone:515-633-3838
Practice Address - Fax:515-633-3837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-06
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA207RC0000X, 207RC0001X, 207RI0011X, 207UN0901X, 208600000X, 2086S0129X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Multi-Specialty
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear CardiologyGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA08012OtherWELLMARK
MN46599OtherHEALTH PARTNER
IA0080127Medicaid
IACS9044OtherPALMETTO RAILROAD MC GRP
IACD4547OtherPALMETTO RAILROAD MC GRP
IA08012OtherWELLMARK